Racial Differences in Attitudes Toward Professional Mental Health Treatment: The Mediating Effect of Stigma

Abstract

Stigma associated with mental illness continues to be a pervasive barrier to mental health treatment, leading to negative attitudes about treatment and deterring appropriate care seeking. Empirical research suggests that the stigma of mental illness may exert an adverse influence on attitudes toward mental health treatment and service utilization patterns by individuals with a mental illness, particularly African Americans. However, little research has examined the impact of stigma on racial differences in attitudes toward seeking mental health treatment. This study examined the hypothesis that stigma partially mediates the relationship between race and attitudes towards mental health treatment in a community-based sample of 101 African American and White older adults. Multiple regression analyses and classic path analysis was utilized to test the partial mediation model. Controlling for socio-demographic factors, African American older adults were more likely to have negative attitudes toward mental health treatment, and they also reported more public and internalized stigma than their White counterparts. As hypothesized, the relationship between race and attitudes toward mental health treatment was partially mediated by internalized stigma, suggesting that internalized stigma may cause older adults to develop negative attitudes about mental health treatment. The partial mediation model was not significant for public stigma, however. Implications for social work research and practice are discussed.

KEYWORDS:

• Stigma
• mental illness
• race
• aging

This study was supported by the Council on Social Work Education Minority Fellowship Award, a Hartford Foundation Pre-Dissertation Award, and the Center on Race and Social Problems at the University of Pittsburgh. Special thanks to Nancy Grote, PhD, Valire Copeland, PhD and Charles F. Reynold, III, MD, for their support and critical review of this article.